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We sought to understand the association between 5-year changes in weight and the future risk of atrial fibrillation, a common heart rhythm disturbance. Overweight, obesity, and underweight were associated with a higher risk of atrial fibrillation compared with normal weight.Gaining weight over a period of 5 years was associated with a higher risk of atrial fibrillation compared with maintaining a stable weight.Graphical Abstract

Atrial fibrillation (AF) is associated with an increased risk of myocardial infarction (MI) and vice versa. This bidirectional association relies on shared risk factors as well as on several direct and indirect mechanisms, including inflammation, atrial ischaemia, left ventricular remodelling, myocardial oxygen supply–demand mismatch and coronary artery embolism, through which one condition can predispose to the other. Patients with both AF and MI are at greater risk of stroke, heart failure and death than patients with only one of the conditions. In this Review, we describe the bidirectional association between AF and MI. We discuss the pathogenic basis of this bidirectional relationship, describe the risk of adverse outcomes when the two conditions coexist, and review current data and guidelines on the prevention and management of both conditions. We also identify important gaps in the literature and propose directions for future research on the bidirectional association between AF and MI. The Review also features a summary of methodological approaches for the study of bidirectional associations in population-based studies.

Graphical Abstract

One of the staple foods in a healthy and sustainable diet is legumes. As such, new dietary guidelines around the globe now include higher intakes of legumes. For example, the most recent Danish dietary guidelines recommend a daily intake of 100 g of cooked legumes. This is, however, far from current intakes. The question is then, how should legumes be (or not be) designed to enable this grand dietary transition necessary to contribute to current global sustainability goals? One option has been to produce legume-based meat alternatives. But is this the only way to go? In this opinion, we debate this solution. We outline the processing, health and climate aspect of legume product consumption and argue that we do not have the right information to be able to appropriately design future legume-based foods. We conclude that processing must be part of the solution as we also need to replace red meat with legumes and re-design traditional meals to include legumes or legume products. Finally, to create the necessary lasting impact for planetary and population health, further dimensions such as food culture, equitability and affordability should also be in focus.

Unhealthy diets, the rise of non-communicable diseases, and the declining health of the planet are highly intertwined, where food production and consumption are major drivers of increases in greenhouse gas emissions, substantial land use, and adverse health such as cancer and mortality. To assess the potential co-benefits from shifting to more sustainable diets, we aimed to investigate the associations of dietary greenhouse gas emissions and land use with all-cause and cause-specific mortality and cancer incidence rates.

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